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Biomedical subjects

M Hoffman

Publications and source records attributed to M Hoffman.

At least 289 records · Page 16Linked to original sources
PubMed1990

[Concomitance of coronary artery disease with acquired aortic valve disease].

Incidence of concomitant coronary disease and extent of coronary artery lesions were assessed in 250 patients with acquired post-rheumatic aortic valve disease treated between 1976 and 1986 in National Institute of Cardiology. Patients' age ranged from 30 to 72 years. Hemodynamic examination with selective coronarography were performed in patients with typical effort or rest angina pain, with electrographically documented myocardial infarction in the past and also in those without (CAD clinical symptoms, but older than 45 years. Patients were divided into two groups: with isolated or dominated aortic valve stenosis (139 patients) and with isolated or dominated aortic valve incompetence. Patients younger and older than 45 years were separately analyzed. Concomitant CAD was proved if at least one coronary artery stenosis was stated. Lesions degree was proportionally graded: stenosis more than 70%, between 50-70% and 20-50% of a vessel lumen in relation to its diameter before lesion. Data were analyzed using ICL ME 29 computer. Study results indicate, that symptoms of coronary failure were observed in 82.8% of patients with acquired aortic valve disease. In 37% of cases there were critical stenoses requiring simultaneous aortic valve replacement with coronary artery by-pass grafting. Severe coronary artery stenosis was stated in 45% of patients with dominated or isolated aortic valve incompetence, whereas only in 29.3% with dominated or isolated aortic valve stenosis. 88.5% of patients younger than 45 years nevertheless coronary failure symptoms had normal coronary arteries.

Adult↗
PubMed1990

[Dissection of the accessory conduction pathways with simultaneous mitral valve surgery].

The case of surgical treatment of a 44-years old female with a double atrio-ventricular accessory pathway and mitral stenosis was described. Fast ventricular rates due to conduction through the accessory pathways during atrial fibrillation in course of mitral stenosis caused severe heart failure, occasionally with deep hypotonia. Combined treatment with prajmaline and propafenone blocked conduction through accessory pathways. The ventricular rate slowed from approx. 200/min to 150/min. Addition of digoxin slowed the ventricular rate down to approx 80-100/min. There were no signs of preexcitation. Treatment with diuretics and vasodilators was continued. The state of patient improved. Echocardiographic and hemodynamic evaluation revealed: mitral stenosis (orifice - 75 mm2) with moderate regurgitation, small aortic and tricuspid regurgitation. The coronary arteries were normal. On the base of the ECG recordings during atrial fibrillation both accessory pathways were localized on lateral and posterior parts of the left free wall. The patient was operated on. Both atrio-ventricular by-pass tracts were dissected using Sealy's method in Cox modification and then mitral valve prosthesis Medtronic-Hall 27 mm was implanted. Prajmaline and propafenone were discontinued and preexcitation did not recovered. The sinus rhythm was restored by electroversion. The patient had no overt heart failure on discharge from the Institute.

Adult↗
PubMed1990

Tuboovarian abscess in postmenopausal women.

A retrospective review was done on all patients at Tampa General Hospital with a surgically confirmed tuboovarian abscess between March 31, 1983, and April 30, 1988. Patients were grouped according to their menopausal status. Sixty-three were identified. Fifty-four were premenopausal and nine postmenopausal. The median ages of the two groups (26 and 52, respectively) were significantly different. The premenopausal patients had a significantly lower median parity and were significantly more likely to have a prior history of gonorrhea and/or pelvic inflammatory disease. The postmenopausal patients were significantly more likely to have contributing medical problems and to have concomitant genital tract pathology. Such pathology, found in 13% of the premenopausal patients, consisted mainly of large leiomyomata uteri. In 3 (33.3%) of the postmenopausal patients there was a strong preoperative suspicion of a coexisting pelvic abscess originating in the genital tract. Two of the patients developed septic shock shortly before surgery. Concomitant pelvic pathology was present in six patients (66.7%), with four of them having genital tract malignancies. An attempt at early recognition and surgical management of tuboovarian abscess is important in postmenopausal women. There is little to be gained by delaying surgical treatment, and the patient is at significant risk of deterioration. In addition, surgical exploration appears to be vital to the recognition and treatment of concomitant pelvic malignancy or other pathologic conditions that may be contributing to the abscess.

Abscess↗
PubMed1989

Comparison of the effects of IL-1 alpha and TNF-alpha on phagocyte accumulation and murine antibacterial immunity.

IL-1 and TNF both are reported to increase host antibacterial resistance. To directly compare their effects on tissue phagocyte accumulation and antibacterial activity, we infused recombinant human IL-1 alpha and TNF-alpha into C3H/HeJ mice. Although IL-1, at a dose of 1 microgram/day, did not significantly elevate blood neutrophil concentrations, it increased the number of PMNs within the spleen three to fourfold within 2 days. Similar neutrophil accumulation also occurred in the lungs, bone marrow, and liver of treated animals without detectable changes in macrophage numbers. IL-1 also increased myelopoiesis in the spleen by Days 3-4 of infusions. The capacity of splenocytes from IL-1-treated animals to kill Listeria monocytogenes in vitro and to suppress listeria proliferation in vivo after the intravenous infusion of bacteria both rose in parallel with PMN accumulation. Comparable doses of TNF also enhanced listeria killing in vivo but in contrast to IL-1, it significantly depressed peripheral blood neutrophil counts, and inhibited splenic neutrophil accumulation and in vitro listericidal activity in listeria-infected mice. Our results suggest that IL-1 enhances host resistance to infection by increasing tissue neutrophil accumulation while TNF protects by a different mechanism, despite a net inhibitory effect on neutrophil accumulation.

Animals↗
PubMed1989

Heparin cofactor II-proteinase reaction products exhibit neutrophil chemoattractant activity.

The physiologic function of the plasma glycoprotein heparin cofactor II (HCII) is not well understood. An in vivo role for thrombin (IIa) inhibition by HCII in the presence of certain glycosaminoglycans (dermatan sulfate and heparin) can be proposed. Many proteins, such as complement components, can be proteolyzed to generate secondary bioactive molecules. HCII is a substrate for the human neutrophil (PMN) proteinases cathepsin G (CG) and elastase (LE). We found that degradation of HCII by CG or LE generated products with potent PMN chemotactic activity, which did not stimulate the PMN oxidative burst. Our results suggest that HCII may be a physiologic regulator of the acute inflammatory response.

Cathepsin G↗
PubMed1989

Stability of parenteral ceftriaxone disodium solutions in frozen and liquid states: effect of freezing and microwave thawing.

The stability of ceftriaxone disodium solutions stored in glass bottles was tested in two parenteral solvents (0.9% NaCl; 5% dextrose) at two concentration rates (10 and 50 mg/mL) and three temperatures (-22 degrees C, 5 degrees C, room temperature). The solutions, which had been initially frozen, were thawed at room temperature or by exposure to microwave radiations. The stability of each sample was determined by a quantitative bacteriological agar gel diffusion assay and by high-performance liquid chromatography. The results of this study indicate that admixtures of ceftriaxone disodium at the concentration rates tested can be frozen for six months without a significant loss in antibiotic activity. At room temperature, the stability is dependent on the concentration of ceftriaxone disodium. At 5 degrees C, the stability is related to the concentration of ceftriaxone and of the solvent. The results obtained by both analytical methods are very close. In order to perform routine assays, the high-performance liquid chromatography method was chosen on the basis of its rapidity and reproducibility.

Ceftriaxone↗
PubMed1989

Severe intrahepatic cholestasis in patients treated with recombinant interleukin-2 and lymphokine-activated killer cells.

Immunotherapy with recombinant interleukin-2 (rIL-2) and lymphokine-activated killer cells (LAK) has become a new form of therapy that has been shown to induce remissions in patients with renal cell carcinoma and melanoma. Despite encouraging results, this form of therapy has been associated with increasing toxicity, often requiring therapy in an intensive-care unit. In this report severe intrahepatic cholestasis occurred in two patients receiving rIL-2 and LAK cells. This form of cholestasis appeared to be directly related to rIL-2 administration at a doses of 2 x 10(6) U/m2 and 3 x 10(6) U/m2 t.i.d. A liver biopsy showed moderate hepatocellular bile stasis, with lobular and portal inflammation. All other studies for potential cause of this cholestasis were negative, including studies for metastatic disease. When therapy was discontinued, evidence for cholestasis and bile stasis resolved. We conclude that rIL-2 is a drug with a potential to induce severe hepatic injury that is reversible upon cessation of therapy with rIL-2. Further care should be exercised when rIL-2 is administered to patients with abnormal liver function.

Adult↗
PubMed1989

Early cervical cancer coexistent with idiopathic inflammatory bowel disease.

Early invasive carcinoma of the cervix may be treated by surgery or radiation therapy. Two patients with early cervical cancer are presented whose concomitant inflammatory bowel disease figured significantly in the selection of surgery as treatment. The use of radiotherapy in the face of inflammatory bowel disease, however, is not clearly addressed in the literature.

Adult↗
PubMed1989

Alpha-macroglobulin secreted by alveolar macrophages serves as a binding protein for a macrophage-derived homologue of platelet-derived growth factor.

Evidence is presented to support our hypothesis that an alpha-macroglobulin (alpha M) produced by lung macrophages serves as a specific binding protein for platelet-derived growth factor (PDGF) from these same macrophages. Culture medium "conditioned" by alveolar macrophages was fractionated by gel filtration according to molecular weight. Proteins larger than 200 kD were bound to greater than 50% of the macrophage-derived PDGF (MD-PDGF) that was extractable by 1 M acetic acid. Another approximately 25% was bound to fractions at approximately 150 kD, and approximately 20% remained unbound. The two high molecular weight fractions inhibited approximately 40% of specific [125I]PDGF binding to rat lung fibroblasts, whereas other fractions did not block PDGF binding to its receptor. Only the greater than 200 kD fractions inhibited the binding of PDGF antisera to purified human PDGF by 20% of control and exhibited specific complex formation and coelution on a gel filtration column with [125I]PDGF. The macrophage-derived alpha M (MD-alpha M) was separated from other macrophage-derived proteins by nickel-affinity chromatography and exhibited clear characteristics of alpha Ms, i.e., cross-reactivity with antibodies to human alpha 2-macroglobulin (alpha 2M) on immunoblots as well as gel migration corresponding to the electrophoretic mobility of the protease-bound "fast" and protease-unbound "slow" forms of human alpha 2M. Nickel-bound protein identified as an alpha M was bound to greater than 50% of the acid-extractable MD-PDGF in macrophage-conditioned medium, supporting the view that the greater than 200 kD protein separated by gel filtration is an alpha M.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Giant Brenner tumor. Case report.

A case is reported of an unusually large benign cystic Brenner tumor. Larger solid tumors have been reported, and, additionally, proliferating Brenner tumors are most often large and cystic. However, the tumor described in this presentation appears to be the largest entirely cystic Brenner tumor reported to date.

Adult↗
PubMed1988

Morbidity profile of the Mamre community.

Various morbidity parameters in Mamre, a village of 4,623 residents in the western Cape, are described. Acute morbidity (either injury or illness) occurring in the 2 weeks before the survey was reported by 4% of respondents. Investigation of several chronic conditions for which people said that they were receiving treatment yielded rates of 57/1,000 for hypertension, 29/1,000 for 'nerves', 13/1,000 for diabetes and 19/1,000 for tuberculosis; 9.9% of respondents reported disability. Reported morbidity increased with age, was commoner in women than in men, and agreed with perceptions of individuals' health. Tuberculosis, inadequate sewerage and water facilities, alcohol abuse and dusty roads were perceived to be the main health problems by the community. The morbidity profile and the relatively high rate of pscyhosocial problems found are consistent with a process of urbanisation in a predominantly working-class community.

Adolescent↗
PubMed1988

Mamre Community Health Project--rationale and methods.

The overall aim of the Mamre Community Health Project is to improve the health status of the people of Mamre and to develop an approach to health promotion which may be applicable to other similar areas. Integral to this is the establishment of a surveillance system to monitor changes longitudinally with particular reference to the effects of interventive programmes and the rural-urban transition that the community is experiencing. A multidisciplinary approach that also involves both postgraduate and undergraduate students will be utilised. This article outlines the methodology employed in the first phase of the project, which was concerned with the collection of the baseline data to determine priorities, plan interventions and establish a suitable surveillance system. Approximately 1,000 households were visited and 5,000 residents interviewed by 10 trained interviewers who were selected from the community. Sampling was not used. Methodological issues addressed include the methods used to gain the co-operation and participation of the community, development of an appropriate questionnaire, selection and training of interviewers, supervision of field-work, coding of data and steps taken to ensure the reliability and validity of information collected. Thorough planning with meticulous attention to detail ensured that the Mamre Community Health Project was completed on target with fairly smooth implementation of the data collection phase. Future research will focus on refining epidemiological methods, especially aspects of study design, case definition and exposure status.

Data Collection↗
PubMed1988

Mamre Community Health Project--demographic, social and environmental profile of Mamre at baseline.

Demographic, social and environmental information was collected from 4,623 residents in 870 Mamre households: 34.3% of the population were under 15 years and 4.4% over 65 years of age, while 2.7% of adults had had no education, 42.1% had only primary school education, 51.1% secondary school education and 4.1% had had some tertiary education. Education and age were inversely related. Of employable adults 64.7% were working. Community, social and personal services and manufacturing accounted for 76% of the male and 92% of the female jobs. Cape Town or Atlantis was the workplace for 78% of male and 87.2% of female workers. Of the labour supply 17.2% were unemployed; 75% of employed people were semi-skilled and unskilled workers. There was a mean of 5.3 persons per household, with a median of 3 rooms per household. Of the houses 18.4% were older than 80 years; 38% of households had inside taps and 98% had outside tap(s). Sewage disposal by the bucket system was used in 86% of households while 13% used flush toilets. The mean amount of money spent on fuel was R10.92 per person per month. The Mamre community is well past the initial phase of rural-urban transition in terms of its sociodemographic profile. At present, critical environmental infrastructural changes are being introduced.

Demography↗
PubMed1988

Community participation in the Mamre Community Health Project.

From the outset, community participation has been a working principle of the Mamre Community Health Project. The health planning approach was the predominant one used in Mamre. Attempts at improving community participation include the involvement of a steering committee elected by community members, the use of local people as interviewers and the feedback of results to the community in an accessible way. The process of negotiation of entry into the community was concluded. While consent and passive participation of the community were achieved, active participation remains a challenge for the future. Means of realistically evaluating community participation need to be developed.

Community Health Services↗
PubMed1988

Anthropometric assessment of children in Mamre.

The nutritional status of the children attending the crèche and the primary school in Mamre was assessed using standards derived by the National Center for Health Statistics in the USA. The results for children aged under 11 years are presented. Of the 75 children at the crèche 9% were below the 3rd percentile of weight for age, 11% below the 3rd percentile of height for age and 1% below the 3rd percentile of weight for height. A significantly larger proportion of boys than of girls were under the 3rd percentile of height for age. Of the 430 primary school children aged under 11 years 10.2% were below the 3rd percentile of weight for age, 10.9% below the 3rd percentile of height for age and 4.4% below the 3rd percentile of weight for height. A significantly larger proportion of primary school boys aged 8-10 years than of girls were below the 3rd percentile of weight for height. Significantly more girls aged 5-7 years than girls aged 8-10 years were underweight for age.

Age Factors↗